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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We examined familial rates of affective disorder and related illness in a cohort of 955 probands studied at five centers in the National Institute of Mental Health Collaborative Study of the Psychobiology of Depression: Boston, Chicago, Iowa City, New York, and St. Louis. Six hundred sixteen of these probands were entered into a family study, and 3423 of their first-degree relatives were evaluated. The probands were divided into five diagnostic groups: schizoaffective-bipolar (n = 37), schizoaffective-depressed (n = 18), bipolar I (n = 151), bipolar II (n = 76), and unipolar (n = 330). The relatives of bipolar I probands had a higher rate of bipolar I illness than the relatives of unipolar probands, but the relatives of unipolar probands did not have a higher rate of unipolar illness than the relatives of bipolar I probands. The relatives of probands with schizoaffective disorder, depressed subtype, had a higher rate of schizophrenia than the relatives of schizoaffective-bipolar probands, suggesting that bipolar schizoaffective disorder may be closer to pure affective disorder while schizoaffective depression may be closer to schizophrenia. An increase in bipolar II illness was also observed in the relatives of bipolar II probands. Overall, these data support the widely accepted distinction between bipolar and unipolar affective disorders.
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PMID:Familial rates of affective disorder. A report from the National Institute of Mental Health Collaborative Study. 357 97

The usefulness of several historical, clinical and biological variables as possible predictors of outcome was tested in a sample of patients with a cross-sectional diagnosis of schizoaffective disorder, depressed type. Four historical items were found to be successful: a family history of chronic schizophrenia, the occurrence of schizophrenic symptoms at some stage of the illness in the absence of depression and an onset of the index episode as exacerbation of previous symptoms (all associated with a relatively poor outcome), and a personal history of previous manic episodes (associated with a relatively good outcome). The various aspects of the clinical picture during the index episode, as well as the response on dexamethasone suppression test, were not found to have any predictive value. These findings confirm that, in patients with a cross-sectional diagnosis of schizodepressive disorder, the previous course of the illness is of crucial importance for prognosis, and support the usefulness of a multiaxial classification of schizoaffective states, taking into account not only cross-sectional symptomatology but also course.
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PMID:Prediction of outcome by historical, clinical and biological variables in schizoaffective disorder, depressed type. 368 63

We report on the impact of specific indexes of the severity and chronicity of parental depression, measures of familial discord, and demographic variables as predictors of impaired adaptive functioning and psychopathology in children. Seventy-two children and their mothers from 37 families were interviewed in person. At least one biological parent in each family had a depressive disorder but neither parent had a history of mania, schizophrenia, or schizoaffective disorder. Almost every measure of severity and chronicity of depression in the biological parents has a statistically significant association with currently impaired adaptation and the presence of a DSM-III-diagnosed disorder in the children, as do the measures of increased discord among married or separated parents. Depression in the mother is more strongly associated with increased psychopathology in the children than is depression in the father.
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PMID:Impact of severity and chronicity of parental affective illness on adaptive functioning and psychopathology in children. 375 60

Consecutively admitted patients with nonmanic psychosis were more likely to meet Research Diagnostic Criteria (RDC) for schizoaffective disorder, depressed type (N = 47), than for psychotic major depression (N = 29) or schizophrenia (N = 21). Although the RDC duration requirements for these three disorders are quite similar, schizophrenics had already experienced much more chronicity as reflected in episode duration, psychosocial impairment during the preceding 5 years, marital status, and low likelihood of prior remission. Schizoaffective patients took intermediate positions in these measures in accord with the majority of follow-up studies comparing these disorders. Although the RDC specify the same array of psychotic symptoms for schizoaffectives and for schizophrenics, these symptoms were significantly more prominent among the schizophrenics. Conversely, although this system also specifies the same list of depressive symptoms for major depression and schizoaffective depression, symptoms of endogenous depression were significantly more prominent in the major depression group. Thus, among functionally psychotic patients, those with schizophrenia-like symptoms have milder and less typical depressive symptoms whereas those with depressive syndromes have fewer and milder schizophrenia-like symptoms.
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PMID:Demographic, historical, and symptomatic features of the nonmanic psychoses. 376 Aug 48

Neuropsychological functioning in schizoaffective disorder, depressed type, was tested by two parallel studies. In Study 1, the Luria-Nebraska Neuropsychological Battery (LNNB) was administered to samples of patients meeting Research Diagnostic Criteria (RDC) for schizodepressive disorder, major depressive disorder or schizophrenia, and to a normal control group. In Study 2, the same test battery was used in patients with a former RDC diagnosis of schizodepressive or major depressive disorder, examined from 2 to 4 years after the index episode, during a phase of remission. Study 1 showed that the performance of schizodepressives on LNNB is, on average, intermediate between those of depressives and schizophrenics, which finding is compatible with the view that RDC schizoaffective depression encompasses a heterogeneous group of syndromes, some of which are related to major depression and some to schizophrenia. Study 2 showed that the mean scores on the LNNB scales Memory and Intellectual processes are significantly higher in patients with a former diagnosis of schizodepressive disorder, which supports the idea that the outcome of these patients is worse, on average, than that of "pure" depressives.
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PMID:Neuropsychological functioning in schizoaffective disorder, depressed type. 381 13

New uses are still being discovered for a number of psychotropic agents that have been available for some time. Among the more important recent discoveries are the efficacy of the tricyclic antidepressants for panic disorder and agoraphobia with panic attacks; the use of the monoamine oxidase inhibitors for the above disorders and for atypical depression and hysteroid dysphoria; the use of propranolol for anxiety disorders and for uncontrollable violent outbursts; the antianxiety and antipanic effects of clonidine; and the usefulness of lithium in treating schizophrenia and schizoaffective disorder and for emotionally unstable character disorders. In addition to strengthening the therapeutic armamentarium, the author says, the discovery of new drug response patterns helps generate or strengthen hypotheses about the pathophysiology of various psychiatric disorders.
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PMID:Newer uses for older psychotropic medications. 612 38

Case histories were reviewed of 25 patients with RDC diagnoses of schizophrenia or schizoaffective disorder who developed a clinical syndrome of depression subsequent to the resolution of their psychotic episodes. Of these patients, 14 were then treated with imipramine and 11 with amitriptyline in addition to their neuroleptic drugs. As a group, the patients did well--48% had a remission of depressive symptoms and an additional 32% improved. Psychotic exacerbation was noted in only one patient. Imipramine seemed more beneficial than amitriptyline in these patients.
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PMID:Response of postpsychotic depression to adjunctive imipramine or amitriptyline. 613 Oct 64

Studies that compare the treatment response of patients diagnosed as primary affective disorder or schizoaffective disorder are reviewed. Although relatively few controlled or uncontrolled studies of the chemotherapy of schizoaffective disorders have been conducted, available evidence suggests that: (1) lithium carbonate is effective in the initial treatment of both schizoaffective mania and mania; (2) antidepressants alone, neuroleptics alone, or their combination can be effective in the initial treatment of both schizoaffective depression and primary depression; and (3) prophylactic administration of lithium carbonate may reduce the frequency and duration of relapse in both schizoaffective manic and schizoaffective depressed patients. Thus, treatment studies indicate that the schizoaffective disorders are very similar to the primary affective disorders with regard to response to pharmacologic treatment. Evidence from this laboratory that schizoaffective manic patients respond more slowly than manic patients to lithium or neuroleptic treatment is presented.
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PMID:Treatment of schizoaffective disorders. 614 25

The authors evaluated 20 patients, diagnosed by Research Diagnostic Criteria after 1 week of hospitalization as having schizophrenia, weekly throughout their hospitalization. Four patients developed syndromes of depression after resolution of their psychoses: three manifesting a "minor" and one a "major" postpsychotic depressive syndrome. Four other patients went on to develop syndromes equivalent to major depression at a time when they were still actively psychotic, and their cross-sectional diagnoses were therefore changed to schizoaffective disorder, depressed type. The authors discuss the implications of these findings for diagnosis.
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PMID:Course-related depressive syndromes in schizophrenia. 648 62

A wide variety of concepts have been proposed to account for schizoaffective psychoses. Presenting a mixture of schizophrenic and affective symptoms, these psychoses have long defied classification in the usual scheme of the two major diagnostic categories, schizophrenia and major affective disorder. Empirical findings are often contradictory, and have sometimes supported the classification of schizoaffective disorder with schizophrenia, and, more recently, with major affective disorders. An alternative hypothesis is that schizoaffective disorder is fundamentally heterogeneous, and that research efforts should be directed toward the identification of homogeneous subtypes. To illustrate the latter research strategy, we describe our current research program of long-term followup and family studies of patients with schizoaffective psychoses and other atypical psychoses. Extensive data have been obtained using blind, structured psychiatric interviews with probands after 30 to 40 years of followup, and with their first degree relatives. In the same way, followup and family data were obtained for patients who met research criteria for schizophrenia, mania, and depression, and for matched surgical controls. By comparing these groups of "typical" psychotic patients with the schizoaffective patients, we can select homogeneous subgroups of schizoaffective patients and analyze their characteristics to refine clinical and research criteria for the differential diagnosis of schizoaffective subtypes.
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PMID:Schizoaffective disorder: concept and reality. 670 77


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